MARTHA FRYE KIENZLE MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

VISITING RESIDENT

License Number

188000638

License Status

EXPIRED

Business

Title

First Name

MARTHA

Middle

FRYE

Last Name

KIENZLE

Business Name

MARTHA FRYE KIENZLE MD

Original Issue Date

05/28/2017

Effective Date

05/28/2017

Expiration Date

11/27/2017

City

ALTON

State

Zip

62002

County

MADISON

Specialty/Qualifier

Pediatrics

Ever Disciplined

LastModifiedDate

01/04/2018